Docetaxel-induced lymphopenia in patients with solid tumors - A prospective phenotypic analysis

BACKGROUND. The quantitative abnormalities of the different peripheral bloo d lymphocyte subsets during docetaxel administration were prospectively stu died. METHODS, Forty-six chemotherapy-naive patients with solid tumors were treat ed with docetaxel either in a 3 weekly (n = 33) or weekly (n = 13) schedule . Twenty patients with central nervous system (CNS) metastatic disease as t he first clinical presentation of cancer and 35 patients with metastatic co lorectal carcinoma treated with chemotherapy were enrolled as controls. The phenotype of peripheral blood lymphocytes was determined by indirect immun ofluorescence using appropriate monoclonal antibodies and fluorescent-activ ate cell sorter analysis. RESULTS. After the administration of the first docetaxel cycle, the absolut e number of peripheral blood lymphocytes (P < 0.005), CD3(+) (P < 0.01), CD 4(+) (P < 0.01), CD8(+) (P < 0.01), and CD56(+) (P < 0.01) but not CD20(+) (P < 0.3) cells was significantly decreased compared with the pretreatment values. Further treatment resulted in a further decrease of these lymphocyt e subsets including CD20(+) cells (P < 0.01). Similarly, after the administ ration of the first weekly dose of docetaxel, the absolute number of total lymphocytes, CD3(+), CD4(+), and CD8(+) cells was decreased. The administra tion of the second weekly docetaxel dose resulted in a further decrease of CD56+ (P = 0.012) and CD20(+) (P = 0.007) cells. The administration of eith er high dose corticosteroids in patients with CNS metastases or an irreleva nt chemotherapy (CPT-11/5-FU) did not result in similar abnormalities. The discontinuation of docetaxel was associated with a recovery of CD3+ and CD4 + lymphocytes within a 3-month period. Eight (17%) patients developed nonne utropenic infections during docetaxel treatment. CONCLUSIONS. Docetaxel has an important but reversible nonspecific lymphope nic effect that seems to be associated with an increased risk for nonneutro penic infections. (C) 2000 American Cancer Society.